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I had an emergency appendectomy while out of state. Within a month, I received bills from the hospital, the surgeon, the anesthesiologist, the assistant anesthesiologist, and the ER physician. Because this was emergency surgery, my high-deductible HMO plan covered everything beyond my (large) out-of-pocket maximum for 2014 and handled all claims filed in a timely manner. Even though all providers involved were outside the (local) network in my HMO, I was assured that I would have no balance-billing issues because the providers were part of some backup agreement my HMO has with a nationwide network in case of emergency out of area treatment.Fast forward to the present: Yesterday's mail contained a surprise bill from the radiologist, the first bill received from this provider almost 13 months after the fact. Why the provider delayed almost 13 months in attempting to bill me is unclear. First thing this morning, I called the (excellent!) member services department of my HMO. My HMO offered to contact the absurdly delinquent billing service to notify them of the proper procedure for submitting a claim. They have done so, but I imagine the claim will ultimately be denied, due to the extremely late filing.
1) Why would a provider wait so ridiculously long before billing a patient?
2) Do I have any responsibility to pay this bill, which my HMO would have paid in full if they had sent me the bill soon enough to allow timely claim filing with the HMO? I had no idea that an independent radiology charge would be billed. (Everything happened in a blur in the ER. Lots of people do random stuff to you and they don't tell you whether their services will be included in the hospital bill or not when they do so.)
3) The hospital obviously gave the provider my name and address so they could bill me. Didn't the hospital also provide my insurance information? (The bill from this provider said "No insurance," which is not true.)
4) How can I prevent this kind of thing in the future? (E.g., if I had asked the hospital at the time of discharge, would they have provided a list of all the names and contact information of all the treating professionals to whom I should reach out and request timely bills?)
I didn't find the right solution from the internet.
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